Want to hear something mind-blowing? 10 centimeters is not the same as being complete. Let me say that again - being 10 centimeters dilated does NOT mean you are complete and ready to start pushing. When a provider checks you and can no longer feel anymore cervix, that is what they call 10 centimeters dilated. However, this is not synonymous with being complete or ready for pushing. In order to be complete, your cervix has to stretch all the way up to your pubic bone anteriorly and to your sacral promontory posteriorly. There is literally no way for providers to know when you've gotten to this point, because they cannot feel that high up with their fingers.
If you start pushing before you are complete, your baby's shoulder can get stuck at your pubic bone and you will end up pushing for a long time. The body wasn't designed to have to push for hours. We are seeing more and more perineal injuries and pelvic organ prolapse from prolonged pushing than ever before. We need to stop encouraging women to start pushing at 10 centimeters. We need to stop encouraging practice pushing. We need to stop coaching women on when and how to push, before they feel ready to. The only way to know if you are ready to push is to wait until your body gives you the overwhelming urge to do so
PS - even with an epidural your body is still capable of performing the fetal ejection reflex.
PPS - if you've been pushing for a while and it just doesn't feel right, stop.